All of the following statements are correct with respect to the CDC’s estimates of HIV infection in the United States EXCEPT for one. Which one is the exception?
A. Approximately 38,000 people become newly infected with HIV each year.
B. An estimated 5 million people are living with HIV.
C. Nearly 14 percent of those infected with HIV are not aware of their infectious status.
D. An estimated 1.1 million people are living with HIV.
HIV is acquired in non-occupational settings either across mucous membranes or parenterally by _______________.
A. unprotected penetrative sex between men
B. sharing utensils such as a spoon or fork
C. injection drug use
D. A and C
All of the following statements are correct with respect to the estimated per exposure risk of HIV transmission EXCEPT for one. Which one is the exception? Following _______________.
A. oral sex it is 0.67
B. receptive anal intercourse it is 1 to 30%
C. insertive anal or receptive vaginal intercourse it is 0.1 to 10%
D. insertive vaginal intercourse it is 0.1 to 1%
All of the following statements with respect to the pattern of disease progression are correct EXCEPT for one. Which one is the exception?
A. After an incubation period of 1 to 3 weeks, 50 to 80 percent of patients experience an ill-defined Acute Retroviral Syndrome.
B. Non-specific signs and symptoms associated with primary infection include malaise, lethargy, and a sore throat, arthralgia, myalgia, headache, photophobia, maculopapular rash and lymphadenopathy.
C. During the period of clinical latency, which typically lasts 8 to 24 years, the patient is usually free of overt illness.
D. The final phase is characterized by the appearance of opportunistic illnesses.
Which of the following oral conditions have been demonstrated to be positive predictors of HIV-associated disease progression?
A. Oral candidiasis
B. Hairy leukoplakia
C. Salivary gland disease
D. A and B
All of the following statements with respect to the diagnosis and staging of HIV infections are correct EXCEPT for one. Which one is the exception?
A. Laboratory criteria for defining a confirmed case now accommodate new multi-test algorithms, including criteria for differentiating between HIV-1 and HIV-2 infection and for recognizing early HIV infection.
B. A confirmed case of HIV infection is now classified in one of five stages (0, 1, 2, 3, or unknown).
C. Early infection, i.e., a positive HIV test within 6 months of HIV diagnosis, is classified as stage 0.
D. If the criteria for stage 0 are not met, the stage is classified as 1, 2, 3, or unknown depending on CD4+ T-lymphocyte test results or whether an opportunistic illness was diagnosed >180 days after the diagnosis of HIV infection.
All of the following statements related to antiretroviral drug therapy is correct EXCEPT for one. Which one is the exception?
A. To reduce the risk of disease progression and to prevent the transmission of the virus to others, antiretroviral therapy (ART) is recommended for all patients with HIV infection.
B. The Food and Drug Administration has approved more than 25 antiretroviral drugs in 4 mechanistic classes.
C. Recommended regimens are those with durable virologic efficacy, favorable tolerability and toxicity profiles, and ease of use (including some newer combinations).
D. Multiple combination formulations are available to improve ease of use and compliance.
Antiretroviral regimens for a treatment-naive patient generally consist of two nucleoside reverse transcriptase inhibitors (NRTIs) plus any of the following EXCEPT for one. Which one is the exception?
A. an integrase strand transfer inhibitor (INSTI)
B. a non-nucleoside reverse transcriptase inhibitor (NNRTI)
C. a protease inhibitor (PI) with a pharmacokinetic booster such as cobicistat or ritonavir
D. another NRTI
All of the following scenarios increase the risk of infection among HCP following percutaneous exposure to HIV-infected blood EXCEPT for one. Which one is the exception?
A. Patient blood was visibly noted on the instrument before exposure.
If the injury involved a needle that was placed directly into the patient’s vein or artery prior to the exposure.
C. If the exposure resulted in profuse bleeding.
D. If the exposure was superficial and resulted in no bleeding.
All of the following statements related to the average risk of HIV transmission following various routes of exposure are correct EXCEPT for one. Which one is the exception?
A. Prospective studies estimate that the average risk for HIV infection after percutaneous exposure to HIV-infected blood is approximately 0.3% (1 infection associated with 2,885 exposures).
B. Prospective studies estimate that the average risk for HIV infection after mucous membrane (eyes, nose, and mouth) is approximately 0.09%.
C. The transmission of HIV infection after nonintact skin exposure is estimated to be higher than the risk following mucous membrane exposure.
D. The risk of infection associated with intact skin is below detection.
All of the following statements related to provider-to-patient transmission of HIV are correct EXCEPT for one. Which one is the exception?
A. Since HIV was isolated, only 4 instances of HIV transmission from infected provider to patient have been documented worldwide and no cases have been reported since 2003.
B. The U.S. cluster involved a dentist, although the precise mechanisms of transmission were never determined.
C. More than 4 dozen look-back studies have been conducted and none of these studies identified evidence of provider-to-patient transmission.
D. The U.S. cluster of a provider to patient transmission was determined to have been the result of intentional malfeasance.
The first step in managing a percutaneous wound to the finger is _______________.
A. to inject the wound with an antiseptic
B. to squeeze the wound to express fluid
C. to flush the wound with water
D. to wash the wound with soap and water
All of the following statements are correct with respect to the process and requirements for determining the risk associated with a percutaneous exposure EXCEPT for one. Which one is the exception?
A. Recording and reporting occupational injuries should be in accordance with state and federal requirements.
B. When an occupational exposure occurs, the circumstances of the incident should be recorded on a form appropriate for the oral healthcare setting.
C. When an occupational exposure occurs one should record the type of fluid (blood, OPIM, concentrated virus) and the type of exposure (percutaneous, mucous membrane, nonintact skin, bites).
D. Ensuring the exposed provider is evaluated within 4 days of the exposure.
All of the following statements are correct with respect to the evaluation and management of the exposed person EXCEPT for one. Which one is the exception?
A. The exposed person should be evaluated within two hours after exposure.
B. The exposed person should have his/her HBV vaccination and response status determined.
C. To establish the HIV status at the time of exposure (baseline), the exposed person should be tested for HIV.
D. PEP prophylaxis should be initiated and completed regardless the HIV status of the patient.
All of the following statements concerning post-exposure prophylaxis (PEP) for healthcare worker potentially exposed to HIV are correct EXCEPT for one. Which one is the exception?
A. PEP should be initiated as soon as possible, preferably within 72 hours after a possible exposure to HIV.
B. Antiretroviral PEP has been shown to be 100% effective in preventing infection.
C. The U.S. Public Health Service no longer recommends that the severity of exposure be used to determine the number of drugs to be offered in an HIV PEP regimen.
D. The recommended 4-week PEP regimen include two NRTIs plus an INSTI, or a NNRTI, or a PI) with a pharmacokinetic booster such as cobicistat or ritonavir.
Elements of post-exposure counseling should include information _______________.
A. about precautions related to donating blood or tissue, becoming pregnant, breastfeeding, and to practice sexual abstinence or safe sex
B. mandatory registration with the appropriate state health agency
C. about possible drug toxicities, drug-drug interactions, measures to be taken to minimize side effects, and methods for clinical monitoring of toxicity
D. A and C
In managing a possible occupational HIV exposure, follow-up testing to monitor HIV seroconversion is indicated at _______________.
A. 1 month, 6 months, and 1 year
B. 12 weeks, 6 months, and 1 year
C. 6 weeks, 12 weeks, and 6 months
D. 6 weeks, 6 months, and 1 year
All of the following statements are correct with respect of SHEA guidelines to minimize provider-to-patient transmission of HIV in healthcare settings EXCEPT for one. Which one is the exception?
A. Infected healthcare providers should be totally prohibited from patient care solely on the basis of an infection with HIV.
B. Clinical privileges should be granted according to the viral load of the infected provider.
C. SHEA guidelines emphasize the importance of Standard and Transmission-based Precautions to minimize HIV transmission.
D. The likelihood of procedure-related provider-to-patient transmission of HIV should be considered when determining the provider’s occupational limitations.
All of the following statements are correct relative to the responsibilities of an HIV infected healthcare provider EXCEPT for one. Which one is the exception?
A. Routine, voluntary, confidential testing of providers is encouraged.
B. HIV-infected clinicians are ethically bound to inform local or state public health authorities of their status.
C. In particular, those clinicians who perform Category III procedures should know their immune or infectious status not only with respect to HIV, but HBV and HCV.
D. HIV infected providers should withdraw from all forms of clinical care.
An HIV infected clinician may perform Category I, II, and III procedures if all the following criteria are met EXCEPT for one. Which one is the exception?
A. There is no evidence of the provider having transmitted infection to patients and obtained advice from an Expert Review Panel about continued practice.
B. The provider demonstrates a viral burden ≥5 x 10
C. Consulted with an expert about optimal infection control procedures and strictly adheres to the recommended procedures.
D. The provider agrees to twice yearly follow-up to verify viral burden levels.